Title: Cardiogenic Shock<br/>Author: Mike Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p>
<strong><u>Pearls for the Patient in Cardiogenic Shock</u></strong></p>
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Cardiogenic shock is generally defined as tissue hypoperfusion due to ineffective cardiac output.</li>
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Despite therapeutic advances, 30-day mortality for cardiogenic shock can reach 50%.</li>
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Though there are several different phenotypes and severity of staging, consider the following pearls in the initial resuscitation of patients with cardiogenic shock:
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Early arterial line placement for accurate blood pressure monitoring.</li>
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Supplemental oxygen to maintain O2 > 90%.</li>
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NIPPV to reduce the work of breathing for patients with pulmonary edema.</li>
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Use of lung-protective ventilation for patients who require intubation and mechanical ventilation.</li>
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Vasopressor and inotrope therapy for hemodynamic support.
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Norepinephrine is the preferred first-line vasopressor. </li>
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Dobutamine or milrinone for inotrope support.</li>
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Early revascularization for patients with cardiogenic shock due to acute MI.</li>
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<fieldset><legend>References</legend>
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Jentzer JC, et al. Advances in the management of cardiogenic shock. <em>Crit Care Med</em>. 2023; 51:1222-1233.</p>
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